Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jun;23(6):328-33.
doi: 10.1016/j.annepidem.2013.02.007. Epub 2013 Mar 25.

Sociodemographic, clinical, and psychological factors associated with attrition in a prospective study of cardiovascular prevention: the Heart Strategies Concentrating on Risk Evaluation study

Claudia E Bambs  1 , Kevin E Kip, Suresh R Mulukutla, Aryan N Aiyer, Cheryl Johnson, Lee Ann McDowell, Karen Matthews, Steven E Reis
Affiliations

Sociodemographic, clinical, and psychological factors associated with attrition in a prospective study of cardiovascular prevention: the Heart Strategies Concentrating on Risk Evaluation study

Claudia E Bambs et al. Ann Epidemiol. 2013 Jun.

Abstract

Purpose: To identify factors associated with attrition in a longitudinal study of cardiovascular prevention.

Methods: Demographic, clinical, and psychosocial variables potentially associated with attrition were investigated in 1841 subjects enrolled in the southwestern Pennsylvania Heart Strategies Concentrating on Risk Evaluation study. Attrition was defined as study withdrawal, loss to follow-up, or missing 50% or more of study visits.

Results: Over 4 years of follow-up, 291 subjects (15.8%) met criteria for attrition. In multivariable regression models, factors that were independently associated with attrition were black race (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.55-3.16; P < .001), younger age (OR per 5-year increment, 0.88; 95% CI, 0.79-0.99; P < .05), male gender (OR, 1.79; 95% CI, 1.27-2.54; P < .05), no health insurance (OR, 2.04; 95% CI, 1.20-3.47; P < .05), obesity (OR, 1.80; 95% CI, 1.07-3.02; P < .05), CES-D depression score 16 or higher (OR, 2.02; 95% CI, 1.29-3.19; P < .05), and higher ongoing life events questionnaire score (OR, 1.09; 95% CI, 1.04-1.13; P < .001). Having a spouse/partner participating in the study was associated with lower odds of attrition (OR, 0.60; 95% CI, 0.37-0.97; P < .05). A synergistic interaction was identified between black race and depression.

Conclusions: Attrition over 4 years was influenced by sociodemographic, clinical, and psychological factors that can be readily identified at study entry. Recruitment and retention strategies targeting these factors may improve participant follow-up in longitudinal cardiovascular prevention studies.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of participants according to categories of study retention. Heart SCORE study, southwestern Pennsylvania, 2007–2011. *Complete data: No missed visits (1 to 4)
Figure 2
Figure 2
Individual and joint associations between race, CES-D depression score ≥16 and study attrition. Heart SCORE study, southwestern Pennsylvania, 2007–2011. CES-D: Center for Epidemiologic Studies Depression Scale
See this image and copyright information in PMC

References

    1. Hartge P. Participation in population studies. Epidemiology. 2006;17:252–254. - PubMed
    1. Morton LM, Cahill J, Hartge P. Reporting participation in epidemiologic studies: A survey of practice. American Journal of Epidemiology. 2006;163:197–203. - PubMed
    1. Galea S, Tracy M. Participation rates in epidemiologic studies. Ann Epidemiol. 2007;17:643–653. - PubMed
    1. Goldberg M, Luce D. Selection effects in epidemiological cohorts: Nature, causes and consequences. Rev Epidemiol Sante Publique. 2001;49 477e492. - PubMed
    1. Szklo M, Nieto F. Epidemiology - beyond the basics. Boston, MA: Jones and Bartlett Publishers; 2004.

Publication types